Does AmeriHealth Coverage Include Rehab and Detox?
If you have an AmeriHealth insurance plan and you are struggling with an addiction to drugs or alcohol, you may be wondering whether or not AmeriHealth covers detox or rehab services. With the introduction of the Affordable Care Act (ACA), which includes substance use disorders (SUDs) as 1 of the 10 elements of essential health benefits, AmeriHealth insurance plans are required to provide services for addiction treatment.1 However, your coverage may vary depending on the type of AmeriHealth plan you have and on your place of residence.
AmeriHealth provides health care to more than 265,000 people in New Jersey and Pennsylvania with a range of services for both individuals and employers.2 Its plans include HMO, PPO, Medicaid, and Medicare.2 Care may be provided through:3
- AmeriHealth Pennsylvania.
- AmeriHealth New Jersey.
- AmeriHealth Caritas.
- AmeriHealth Administrators.
- AmeriHealth Casualty Services.
Does AmeriHealth Cover Rehab?
Yes, most plans cover at least some of the costs of alcohol and drug addiction treatment. If you have an AmeriHealth insurance plan, the company will first determine if your treatment is medically necessary before covering any costs.
Depending on your insurance plan, limits may be placed on the number of days you have coverage for detox in a calendar year, the number of days you can be in an inpatient program in a calendar year, and how many days of outpatient visits are covered in a calendar year.
Additionally, the services that are covered by your AmeriHealth plan may vary.
What Treatment Length Will AmeriHealth Cover?
The length of the treatment plan may be something that your insurer considers when it is determining whether or not it will cover your treatment. In some cases, it may cover a treatment plan with a short duration, but it may resist covering a longer treatment plan.
While treatment length varies depending on various factors, including the substance that has been abused, how long the substance has been abused, and if there are co-occurring disorders, any length of treatment is important and helps patients work toward their recovery. However, research has shown that adequate treatment length makes patients more likely to find success with their treatment.4 So, make sure to work with AmeriHealth to receive the length of treatment that will best help you.
If you have your insurance through your employer, there is no need to worry about your privacy. When you use your coverage for addiction treatment, it is always confidential and discreet.
The cost of alcohol or drug addiction treatment may appear to be an obstacle, but we are here to help. Insurance may cover all or some of your rehab.
Find out if your insurance covers long-term addiction rehabilitation.Check Online Now
Specialty Alcohol and Drug Treatment Through AmeriHealth
There are public facilities that offer a wide range of treatment options. However, some people dealing with SUDs may prefer treatment from a luxury facility. If you have a mental health issue, for instance, you must find a treatment plan that can address those issues. If you need to work while in treatment, you may need to find a facility with executive amenities. Luxury and executive rehab provide additional options for patients with the possibility of AmeriHealth covering at least some of the costs.
What Does AmeriHealth Cover for Addiction Treatment?
With most AmeriHealth plans covering at least some of the costs of treatment for alcohol addiction or drug addiction, the types of treatment can vary in intensity and frequency. Types of treatment may include:
- Inpatient or residential treatment.
- Partial hospitalization.
- Intensive outpatient programs.
- Outpatient treatment.
Inpatient Addiction Treatment vs. Outpatient Addiction Treatment
When you decide to get treatment for a drug or alcohol addiction, you will need to decide what type of treatment is best for you. With inpatient treatment, you receive treatment and live at the facility. Inpatient treatment typically involves group and/or individual therapy. It is often recommended for individuals with:5
- Additional (co-occurring) mental health issues.
- Little outside support.
- Home environments that don’t lend themselves to sobriety.
- Poor treatment outcomes in the past.
Outpatient treatment programs provide treatment during the day or evening but you return home at night. Treatment is similar to that of inpatient programs and you typically receive individual and/or group therapy. Outpatient programs may allow patients to continue going to work or attending school while they receive treatment.5 It is often recommended for patients who have extensive social supports and will not be in an environment that threatens their recovery.
Depending on your insurance plan, AmeriHealth may cover either inpatient or outpatient care.
How to Cover What Insurance Won’t
If you need addiction treatment that your insurance won’t cover, there are other options available. Your insurance provider may be willing to pay for certain services and to give you a discount on services that it does not cover. Even without insurance coverage, you can still get treatment. Many facilities offer payment plans and other financing options to help you get the care you need.
Verifying Coverage and Finding the Best Treatment
If you have questions about what your AmeriHealth insurance plan covers, you can contact AmeriHealth. Or, you can reach out to one of our admissions navigators at +1 (888) 341-7785 . They are available 24/7 and can verify your coverage, answer your questions, and help you find the best treatment plan. In addition, you can click here to check your benefits.
(Please note: Rehabs.com strives to provide you with the most updated information on each carriers’ addiction insurance coverage but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels. Rehabs.com is an informational site only and is not affiliated or sponsored by AmeriHealth.)
Health Insurance Providers and Coverage Levels
- Abraham, A.J., Andrews, C.M., Grogan, C.M., D’Aunno, T., Humphreys, K.N., Pollack, H.A., Friedmann, P.D. (2017). The Affordable Care Act Transformation of Substance Use Disorder Treatment. AM J Public Health, 107(1): 31-32.
- AmeriHealth. (n.d.). About AmeriHealth.
- AmeriHealth. (n.d.). AmeriHealth Companies.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): How long does drug addiction treatment usually last?
- Kaiser Permanente. (2020). Inpatient and Outpatient Treatment for Substance Use Disorder.